{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:37:13Z","timestamp":1790390233223,"version":"4.1.0"},"reference-count":34,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,6]]},"abstract":"<jats:p>Local therapies have been proposed as safe and effective alternatives to systemic drugs in cutaneous leishmaniasis (CL), especially among less severe cases. However, they are not widely available and used in endemic places, including Colombia, which has a high burden of disease. Further complicating the uptake of local therapies is that different treatment guidelines have been established by the World Health Organization (WHO) and Pan American Health Organization (PAHO). Using data from a large referral center in Colombia, we determined the proportion of patients who would be eligible for and potentially benefit from local therapies according to both international guidelines. The sample included 1,891 confirmed cases of CL aged \u2265 12 years, mostly infected with <jats:italic>Leishmania Viannia panamensis<\/jats:italic> (91%, <jats:italic>n<\/jats:italic> = 601\/660), between 2004 and 2014. Overall, 57% of the sample had one lesion, whereas another 31% had two to three lesions. For 74% of patients, all lesions were in an area other than head or neck. The maximum lesion size was \u2264 3 cm for 58% and &lt; 5 cm for 88% of the sample. Based on our data, up to 56% of patients could have been eligible for local therapies according to the WHO criteria. By contrast, only 23% were eligible according to the more restrictive PAHO criteria. Regardless, these data suggest that a substantial proportion of CL patients in Colombia may benefit from local therapies given their relatively mild presentation of disease and low risk of complications. Individualized risk\u2013benefit assessment and guideline adjustments may increase local therapy eligibility and benefit a large number of patients.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0643","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T07:54:42Z","timestamp":1546934082000},"page":"306-310","source":"Crossref","is-referenced-by-count":8,"title":["Eligibility for Local Therapies in Adolescents and Adults with Cutaneous Leishmaniasis from Southwestern Colombia: A Cross-Sectional Study"],"prefix":"10.4269","volume":"100","author":[{"given":"Andr\u00e9s Felipe","family":"Uribe-Restrepo","sequence":"first","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM), Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Dario","family":"Prieto","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM), Cali, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Cossio","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM), Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayur M.","family":"Desai","sequence":"additional","affiliation":[{"name":"Yale School of Public Health, New Haven, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Mar","family":"Castro","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM), Cali, Colombia;"},{"name":"Universidad Icesi, Cali, Colombia;"},{"name":"European Vaccine Initiative, Universit\u00e4tsKlinikum Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","author":"WHO","year":"2017"},{"key":"b2","series-title":"Infect Dis Clin North Am","first-page":"293","article-title":"Cutaneous and mucocutaneous leishmaniasis","volume":"26","author":"Goto","year":"2012"},{"key":"b3","series-title":"Lancet Infect Dis","first-page":"342","article-title":"New world cutaneous leishmaniasis in travellers","volume":"6","author":"Schwartz","year":"2006"},{"key":"b4","series-title":"Informe Del Evento Leishmaniasis, Hasta El Periodo Epidemiologico XIII, Colombia, 2017","author":"Instituto Nacional de Salud\u2013Colombia","year":"2018"},{"key":"b5","series-title":"Int J Infect Dis","first-page":"e525","article-title":"Recent advances in leishmaniasis treatment","volume":"15","author":"Tiuman","year":"2011"},{"key":"b6","series-title":"Leishmaniasis En Las Am\u00e9ricas: Recomendaciones Para El Tratamiento","author":"Organizaci\u00f3n Panamericana de la Salud","year":"2013"},{"key":"b7","series-title":"J Infect Dis","first-page":"684","article-title":"Noninferiority of miltefosine versus meglumine antimoniate for cutaneous leishmaniasis in children","volume":"205","author":"Rubiano","year":"2012"},{"key":"b8","series-title":"Control of the Leishmaniases: Report of a Meeting of the WHO Expert Committee on the Control of Leishmaniases","author":"WHO","year":"2010"},{"key":"b9","series-title":"PLoS One","first-page":"e0184777","article-title":"Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: a systematic review","volume":"12","author":"Brito","year":"2017"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"852","article-title":"Intralesional pentamidine: a novel therapy for single lesions of Bolivian cutaneous leishmaniasis","volume":"94","author":"Soto","year":"2016"},{"key":"b11","series-title":"PLoS One","first-page":"e0122569","article-title":"Efficacy of thermotherapy to treat cutaneous leishmaniasis: a meta-analysis of controlled clinical trials","volume":"10","author":"Cardona-Arias","year":"2015"},{"key":"b12","series-title":"Am J Trop Med Hyg","first-page":"257","article-title":"Intralesional meglumine antimoniate for treatment of cutaneous leishmaniasis patients with contraindication to systemic therapy from Rio de Janeiro (2000 to 2006)","volume":"87","author":"Vasconcellos Ede","year":"2012"},{"key":"b13","series-title":"Int Health","first-page":"153","article-title":"Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis","volume":"4","author":"Blum","year":"2012"},{"key":"b14","series-title":"Am J Trop Med Hyg","first-page":"359","article-title":"Clinical and epidemiologic profile of cutaneous leishmaniasis in Colombian children: considerations for local treatment","volume":"89","author":"Blanco","year":"2013"},{"key":"b15","series-title":"Leishmaniasis: Informe Epidemiol\u00f3gico En Las Am\u00e9ricas","author":"Organizaci\u00f3n Panamericana de la Salud","year":"2017"},{"key":"b16","series-title":"Clin Infect Dis","first-page":"1539","article-title":"Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH)","volume":"63","author":"Aronson","year":"2016"},{"key":"b17","series-title":"Mem Inst Oswaldo Cruz","first-page":"37","article-title":"Monoclonal antibodies for the identification of New World Leishmania species","volume":"91","author":"Grimaldi","year":"1996"},{"key":"b18","series-title":"Am J Trop Med Hyg","first-page":"86","article-title":"Epidemiologic, genetic, and clinical associations among phenotypically distinct populations of Leishmania (Viannia) in Colombia","volume":"59","author":"Saravia","year":"1998"},{"key":"b19","series-title":"PLoS Negl Trop Dis","first-page":"e0005459","article-title":"Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis","volume":"11","author":"Berger","year":"2017"},{"key":"b20","series-title":"J Evid Based Med","first-page":"81","article-title":"Cost-effectiveness analysis of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis","volume":"10","author":"Cardona-Arias","year":"2017"},{"key":"b21","series-title":"Trop Med Int Heal","first-page":"274","article-title":"Drug policy for visceral leishmaniasis: a cost-effectiveness analysis","volume":"12","author":"Vanlerberghe","year":"2007"},{"key":"b22","series-title":"Int J Dermatol","first-page":"506","article-title":"American tegumentary leishmaniasis (ATL) in Rio de Janeiro State, Brazil: main clinical and epidemiologic characteristics","volume":"39","author":"de Oliveira-Neto","year":"2000"},{"key":"b23","series-title":"Trans R Soc Trop Med Hyg","first-page":"55","article-title":"Risk factors for mucosal manifestation of American cutaneous leishmaniasis","volume":"99","author":"Machado-Coelho","year":"2005"},{"key":"b24","series-title":"PLoS Negl Trop Dis","first-page":"e0005713","article-title":"Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis","volume":"11","author":"Mart\u00ednez-Valencia","year":"2017"},{"key":"b25","series-title":"J Infect Dis","first-page":"1018","article-title":"Persistence of Leishmania parasites in scars after clinical cure of American cutaneous leishmaniasis: is there a sterile cure?","volume":"189","author":"Mendon\u00e7a","year":"2004"},{"key":"b26","series-title":"Trans R Soc Trop Med Hyg","first-page":"367","article-title":"Long-term follow-up of patients with Leishmania (Viannia) braziliensis infection and treated with Glucantime\u00ae","volume":"84","author":"Netto","year":"1990"},{"key":"b27","series-title":"Clin Infect Dis","first-page":"1255","article-title":"Intralesional antimony for single lesions of Bolivian cutaneous leishmaniasis","volume":"56","author":"Soto","year":"2013"},{"key":"b28","series-title":"Trials","first-page":"58","article-title":"Thermotherapy. An alternative for the treatment of American cutaneous leishmaniasis","volume":"13","author":"L\u00f3pez","year":"2012"},{"key":"b29","series-title":"Rev Inst Med Trop Sao Paulo","first-page":"197","article-title":"Termoterapia efectiva y m\u00e1s segura que la miltefosina en el tratamiento de la leishmaniasis cut\u00e1nea en Colombia","volume":"55","author":"L\u00f3pez","year":"2013"},{"key":"b30","series-title":"Trans R Soc Trop Med Hyg","first-page":"642","article-title":"Heat therapy for cutaneous leishmaniasis elicits a systemic cytokine response similar to that of antimonial (glucantime) therapy","volume":"100","author":"Lobo","year":"2006"},{"key":"b31","series-title":"PLoS Negl Trop Dis","first-page":"e2130","article-title":"Methodology of clinical trials aimed at assessing interventions for cutaneous leishmaniasis","volume":"7","author":"Olliaro","year":"2013"},{"key":"b32","series-title":"Am J Trop Med Hyg","first-page":"426","article-title":"Epidemiological and clinical changes in American tegumentary leishmaniasis in an area of Leishmania (Viannia) braziliensis transmission over a 20-year period","volume":"86","author":"Jirmanus","year":"2012"},{"key":"b33","series-title":"Epidemiological Report of the Americas","article-title":"Leishmaniasis","author":"PAHO\/WHO","year":"2018"},{"key":"b34","series-title":"Trends Parasitol","first-page":"552","article-title":"Leishmaniasis and poverty","volume":"22","author":"Alvar","year":"2006"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/2\/article-p306.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/2\/article-p306.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/2\/article-p306.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T20:44:42Z","timestamp":1722458682000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/2\/article-p306.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,6]]},"references-count":34,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0643","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,6]]}}}